Buprenorphine Microinduction Treatment in Tri-Diagnosis Patients with Opioid Use Disorder and Chronic Non-Cancerous Pain

Curr Pain Headache Rep. 2026 Apr 10;30(1):39. doi: 10.1007/s11916-026-01478-4.

ABSTRACT

Tri-diagnosis patients cause prevalent economic and healthcare burdens. A tri-diagnosis patient presents with three concurrent conditions: a mental illness, a substance use disorder, and an additional chronic medical condition. The medical conditions of interest include chronic non-cancerous pain (CNCP) and co-occurring with opioid use disorder (OUD). These patients are complex to treat, and an intensive outpatient program (IOP) would be appropriate to address the severity of their symptoms. OUD is prevalent among this population, especially for those in poverty, and in the United States generally. However, it is not fully addressed in the United States, and for those who receive treatment, only 25% will receive medication-assisted treatment. Buprenorphine Microdosing Induction (BPMI), often referred to as the Bernese method, is a novel approach traditionally used in opioid use disorder (OUD) treatment. It can serve as medication-assisted treatment for OUD treatment and pain management simultaneously in an IOP. Because buprenorphine is a partial-opioid agonist, it mitigates withdrawal symptoms and side effects of opioid withdrawal while still providing analgesic effects. Furthermore, this article describes the protocol of BPMI for tri-diagnosis patients who are struggling with OUD and chronic pain and explores the substantial positive outcomes and higher efficacy in contrast to opioids.

PMID:41961202 | DOI:10.1007/s11916-026-01478-4